Use of the Amplatzer Vascular Plug for embolization of a large retroperitoneal shunt during transjugular intrahepatic portosystemic shunt creation for gastric variceal bleeding.

A patient undergoing transjugular intrahepatic portosystemic shunt (TIPS) creation for gastric variceal hemorrhage was found to have a very large spontaneous splenorenal shunt requiring embolization after successful TIPS creation. The anticipated site of embolization was short and large in diameter and was therefore poorly suited for the use of conventional devices such as coils. Two Amplatzer Vascular Plugs and two platinum coils were used to occlude the shunt rapidly and completely.